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Review
. 2022 Jul 29;3(3):e224.
doi: 10.1097/PG9.0000000000000224. eCollection 2022 Aug.

Advances in Pediatric Diagnostic Endoscopy: A State-of-the-Art Review

Diana G Lerner  1 , Ali Mencin  2 , Inna Novak  3 , Clifton Huang  4 , Kenneth Ng  5 , Richard A Lirio  6 , Julie Khlevner  2 , Elizabeth C Utterson  7 , Brendan R Harris  7 , Ryan T Pitman  7 , Sabina Mir  8 , Roberto Gugig  9 , Catharine M Walsh  10 , Doug Fishman  11
Affiliations
Review

Advances in Pediatric Diagnostic Endoscopy: A State-of-the-Art Review

Diana G Lerner et al. JPGN Rep. .

Abstract

Pediatric endoscopy has revolutionized the way we diagnose and treat gastrointestinal disorders in children. Technological advances in computer processing and imaging continue to affect endoscopic equipment and advance diagnostic tools for pediatric endoscopy. Although commonly used by adult gastroenterologists, modalities, such as endomicroscopy, image-enhanced endoscopy, and impedance planimetry, are not routinely used in pediatric gastroenterology. This state-of-the-art review describes advances in diagnostic modalities, including image-enhanced endoscopy, confocal laser endomicroscopy, optical coherence tomography, endo functional luminal imaging probes, wireless motility/pH capsule, wireless colon capsule endoscopy, endoscopic ultrasound, and discusses the basic principles of each technology, including adult indications and pediatric applications, safety cost, and training data.

Keywords: EUS; chromoendoscopy; colon capsule; confocal laser endomicroscopy; endoflip; endoscopy; optical coherence tomography; pediatric; therapeutic endoscopy; wireless motility capsule.

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Conflict of interest statement

Dr Lerner is the founder of Lerner Inc. The other authors report no conflicts of interest.

Figures

FIGURE 1.
FIGURE 1.
CLE of the terminal ileum. (A) Normal epithelial barrier and no extravasation of fluorescein is seen. In (B), a dysfunctional epithelial barrier with extravasation of fluorescein (yellow arrow). CLE = confocal laser endomicroscopy.
FIGURE 2.
FIGURE 2.
Fourteen-year-old with recurrent pancreatitis. EUS showed the PD connecting with the minor papilla diagnosis pancreas divisum. EUS = endoscopic ultrasound; PD = pancreatic duct.
FIGURE 3.
FIGURE 3.
Two patients with PRSS1 mutation, show dilated pancreatic duct (blue dotted line), atrophy of parenchyma, stone (red arrow), and calcifications.
FIGURE 4.
FIGURE 4.
Thirteen-year-old girl with pancreatic tumor. Fine needle aspiration diagnosed a pseudopapillary tumor.
FIGURE 5.
FIGURE 5.
Sixteen-year-old with a stone in the common bile duct (blue arrow).
FIGURE 6.
FIGURE 6.
Sixteen-year-old with chronic abdominal pain. (A) Gastric submucosal lesion seen in the stomach on EGD. (B) EUS with GIST. EGD = esophagogastroduodenoscopy; EUS = endoscopic ultrasound; GIST = gastrointestinal stomal tumor.
FIGURE 7.
FIGURE 7.
EUS showing the alternating light/dark pattern seen between the bowel wall layers (antrum). Small lesion is a submucosal mass. EUS = endoscopic ultrasound.
FIGURE 8.
FIGURE 8.
Fifteen-month-old with abdominal pain and vomiting, US and CT showed a mass in the duodenum. EGD showed compression of duodenum, and EUS showed duplication cyst with debris as shown in this image. EUS = endoscopic ultrasound.
FIGURE 9.
FIGURE 9.
Endoscopic ultrasound in pancreatitis. (A) Computerized tomography image showing pancreatic pseudocyst (asterisk), (B) endoscopic image showing pseudocystogastrostomy plastic stent in situ (white arrow), and (C) fluoroscopic image confirming placement of pseudocytogastrotomy stent (black arrow).
FIGURE 10.
FIGURE 10.
Fifteen-year-old with portal hypertension and gastric varices (with feeding vessel).
See this image and copyright information in PMC

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